Provider Demographics
NPI:1508909193
Name:BURNS, REBEKAH MAE (RD)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:MAE
Last Name:BURNS
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:BURNS
Other - Last Name:SAAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5345 PEACH DR
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-2778
Mailing Address - Country:US
Mailing Address - Phone:864-430-2425
Mailing Address - Fax:
Practice Address - Street 1:5345 PEACH DR
Practice Address - Street 2:
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-2778
Practice Address - Country:US
Practice Address - Phone:864-430-2425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2025-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN967539133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered